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Ureteroscopy at Our Los Angeles Center

Ureteroscopy is a minimally invasive procedure that can be used to diagnose and treat disorders in the ureters. These are the tiny tubes that carry urine from the kidneys into the bladder. If these tubes are obstructed or diseased, this can cause a number of unpleasant or troubling symptoms including:

  • Blood in the urine
  • Suspicious cells in a urine sample (potentially indicating a cancerous lesion)
  • Recurring urinary tract infections
  • Decreased urine output from narrowing of the ureter due to swelling, scarring, infection or the presence of a growth (polyp or tumor)
  • Kidney stones that have traveled into the ureter (these may be painful or may simply interfere with normal urination)
  • Pain in the kidney (this can occur due to swelling from backed up urine if the ureter is completely blocked)

 

About the Ureteroscope

This instrument is a long and flexible fiber-optic viewing tool. A ureteroscope and cystoscope are similar and the terms are sometimes used interchangeably. However, some types of cystoscopes are more rigid and not as suitable for viewing the upper regions of the urinary tract. The appropriate scope is selected based on the type of diagnostic procedure being done. The ureteroscope has one or more hollow channels that can carry additional tools into the ureters. These instruments may include a laser to break up stones in the ureters or a tiny basket that can capture them and draw them out. The size and composition of the stones (what types of material they are made of) as well as their location determines whether it is best to dissolve them or retrieve them.

Ureteroscopy Procedure Overview

A urine sample is taken before the procedure to check for infection (since this may cause complications). Unlike cystoscopy which may be done under local anesthesia, spinal or general anesthesia is often used when scoping the ureters to ensure maximum comfort and help the patient remain still. This means patients will need to fast as instructed by their urologist before the procedure. They will also need to plan for someone to drive them home after this outpatient procedure.

The patient starts with an empty bladder and lies back on the procedure table with knees up and apart. The legs and abdomen are covered with drapes and the area around the urethral opening is cleaned to limit bacteria from being picked up by the scope. The ureteroscope is lubricated and slowly inserted up through the urethra into the bladder. The bladder is filled with a sterile liquid to stretch the tissues out for optimal viewing. The scope is extended up into the ureter to check for growths, stones or other blockages. This step is repeated for the other ureter. A biopsy is taken if a growth is found. A stone will be removed if it is small enough for treatment with the ureteroscope tools. The procedure generally takes less than half an hour. It may take another hour or two for the effects of spinal or general anesthesia to wear off enough for the patient to feel comfortable walking around and ready to be driven home.

Common side effects include minor bleeding and a burning sensation during urination. These symptoms should go away within a day of the procedure. Drinking lots of water and applying a warm compress to the urethral opening as directed may ease discomfort. Serious complications such as systemic infection, scarring of the urethra and perforation of the urinary tract or bladder are rare. Pain, ongoing bleeding or fever should be reported immediately.

Benefits of Ureteroscopy

This procedure is often an effective way to remove kidney stones lodged in the ureters. This means patients can feel confident seeking treatment at the first signs of trouble instead of waiting for stones to become large and very painful. The scope also provides a minimally invasive way to check for and sample abnormal cells in the ureters to identify and treat serious illnesses sooner. Most patients find this treatment is not as uncomfortable as they imagined. While it isn’t necessarily a “lunchtime” procedure, it is fast and effective with a quick recovery for most patients.

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